S42
ICD-10Non-billable categoryFracture of shoulder and upper arm
Official ICD-10-CM descriptor (FY2026)
Fracture of shoulder and upper arm
S42 is a category heading, not a billable code. CMS does not accept it on a claim; report one of the more specific codes beneath it.
Excludes1
Not coded here. An Excludes1 code should never be reported at the same time as the code above it.
- traumatic amputation of shoulder and upper arm (S48.-)
Excludes2
Not included here. The condition is not part of this code, but a patient may have both, and both codes may be reported together.
- periprosthetic fracture around internal prosthetic shoulder joint (M97.3)
Notes
- A fracture not indicated as displaced or nondisplaced should be coded to displaced
- A fracture not indicated as open or closed should be coded to closed
7th character
- The appropriate 7th character is to be added to all codes from category S42
Permitted 7th characters
| A | initial encounter for closed fracture |
| B | initial encounter for open fracture |
| D | subsequent encounter for fracture with routine healing |
| G | subsequent encounter for fracture with delayed healing |
| K | subsequent encounter for fracture with nonunion |
| P | subsequent encounter for fracture with malunion |
| S | sequela |
More specific codes under S42
Where this code sits
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ICD-10-CM FY2026. Centers for Medicare & Medicaid Services (CMS) / National Center for Health Statistics (NCHS), “2026 ICD-10-CM Code Descriptions in Tabular Order” (icd10cm_order_2026.txt). Download the original file from cms.gov. Public domain (US Government work). Descriptors, billable flags and instructional notes on this page are reproduced from that file without modification. Krasyn adds no clinical guidance.